How do you feel about the waiting period for HRT?

[Arch]

By long, I mean that in some countries, the health system is run by people who apply a one-size-fits-all policy where everybody has to wait 1-2 years before starting HRT no matter what.  Years is too long, and potentially lethal.

Okay, I see now--and I agree--but the OP specifically asks about the SoC suggested three-month therapy period, so that's what I focused on. These other systems clearly aren't going by that.

[Arch]

My young life, how ever long or short it may be, is beside the point. ANY time wasted, is time I'll never see again, and its time being wasted of that period.

She in fact said "... it's a generational thing, too, I think, for those brought up on instant gratification", which implies that it's a generation brought up on instant gratification, in that context, "for those" indicates "for those of that generation".

Only she can clarify what she meant, but that's how I interpret it.

It is certainly implied that younger generations tend to expect instant gratification, but that's hardly a novel observation; it's in the news on a regular basis. My point is that "for those of that generation" implies that there are also some of that generation who weren't raised on the instant gratification model.

Neither one of us lives in a completely "free" country; these systems have their advantages and disadvantages. One benefit of the three-months-of-therapy guideline is that it protects people who need to be protected. Maybe you feel that you don't need protection, but I'm sure a lot of vulnerable people who do need protection feel that they don't need it, either. If any client's word is enough, these people won't be protected, and, quite possibly, neither will those around them. Because three months is only a guideline and not a requirement, a therapist can easily say, "You don't need three months; I'll write your letter this week, and you can pick it up on Tuesday." Or, conversely, "This client has serious issues and shouldn't go on HRT yet." Unless, of course, the system is effed up--which is a somewhat different issue, as is the comparison of subsidized non-subsidized systems.

There's always informed consent in countries where it is available. Of course, you generally have to pay out of pocket for that. There's always something.

[Asfsd4214]

It is certainly implied that younger generations tend to expect instant gratification, but that's hardly a novel observation; it's in the news on a regular basis. My point is that "for those of that generation" implies that there are also some of that generation who weren't raised on the instant gratification model.

Neither one of us lives in a completely "free" country; these systems have their advantages and disadvantages. One benefit of the three-months-of-therapy guideline is that it protects people who need to be protected. Maybe you feel that you don't need protection, but I'm sure a lot of vulnerable people who do need protection feel that they don't need it, either. If any client's word is enough, these people won't be protected, and, quite possibly, neither will those around them. Because three months is only a guideline and not a requirement, a therapist can easily say, "You don't need three months; I'll write your letter this week, and you can pick it up on Tuesday." Or, conversely, "This client has serious issues and shouldn't go on HRT yet." Unless, of course, the system is effed up--which is a somewhat different issue, as is the comparison of subsidized non-subsidized systems.

There's always informed consent in countries where it is available. Of course, you generally have to pay out of pocket for that. There's always something.

We'll have to agree to disagree, I think informed consent should be more universal.

Anyway, guess it doesn't matter now, I escaped the 3 month rule through the harm reduction loophole (was self medicating). And I don't for a moment regret it.

[Summerfall]

If we were subjecting our neighbors to sex steroids against their will, I doubt it would take 3 months for a court injunction to put a stop to it. Except it's not our neighbors that we are forcing the steroids on, it's ourselves, and HRT is the injunction.

Also, I question the authority of the whole "gatekeeper" system. Although it's easy to become enamored with our western medicine and all its marvels, if we really take a look inside it, it doesn't live up to it's hype. There are plenty of cases where physicians ignore a patient's assertions, only to learn in the end that these assertions were not only important, but critical. Ask survivors of many long-term illnesses, and they will tell you that one of the most important lessons they took away from their experience was to trust their gut and find a health care team that would do the same. That isn't a greedy "me, me, me" attitude, it's a trait that will actually increase our chances of having a positive outcome, of surviving.

[Arch]

We'll have to agree to disagree, I think informed consent should be more universal.

Actually, I do, too--with proper emphasis on "informed." I don't believe the practitioner providing the services should just dispense hormones willy-nilly to anybody who wanders in off the streets--the provider absolutely must make sure that the patient/client seems to have the ability to truly be informed and to take responsibility for his or her actions.

In my community, I've heard that a certain person was refused hormones at the informed consent clinic because he/she was clearly not operating on all thrusters. I think this was a good move. On the other hand, the same clinic approved a couple of people whom I know to be very unstable; I was surprised that even the informed consent clinic gave them the go-ahead. One of these people apparently came close to committing suicide, or maybe he actually tried and was hospitalized (he was very vague about the details). So I worry that some clinics (maybe even the one in my city) don't screen people adequately. That's my main objection to informed consent clinics; I think they should do a good job of weeding out certain people. If someone has serious mental health issues and/or isn't quite stable, is that person capable of being fully informed and fully consenting? I say no, not necessarily. In short, I don't think "informed consent" should mean that absolutely everybody should be able to do absolutely anything, even with their own bodies.

[Asfsd4214]

I was originally against any waiting period, thinking that it was simply "gatekeeping". After having hung around here and the chat rooms, as well as other sites, I see why the SOC's call for a period of consultation with a therapist..

And remember, as has been mentioned before, that they are only guidelines.. Your therapist may decide after only a few sessions that you are ready for HRT, or may decide you need additional therapy before HRT. Just because you think you are ready, doesn't mean you really are..

I've only had 1 session with my therapist so far, but found it quite constructive. I will be going back and following through his process.

Except they're not only guidelines... many therapists consider them as rules, and they say that it requires three months minimum.

Several of the therapists I saw in the beginning had their own make believe SOC that said you have to have about a year of RLE before HRT.

I just don't have a lot or respect for any of these systems.

[Nero]

  But I do think that perhaps age should be one of the factors in deciding how quickly someone can access hormones, etc.  A 2-year wait for a 54 year old is not the same thing as a 2-year wait for a 25 year old...

Colleen,
While I don't think it was intentional, this comment comes off as a little dismissive of younger trans people. While a younger person may have a projected longer life as themselves (projected, not guaranteed), there are other considerations as well. For a young trans woman for instance, 2 years could mean the difference between needing FFS or not, hair transplants or not, or thousands more on her electrolysis bill.
And once that bell rings for transition, every day spent waiting is a lifetime, no matter the age.

[Cowboi]

Colleen,
While I don't think it was intentional, this comment comes off as a little dismissive of younger trans people. While a younger person may have a projected longer life as themselves (projected, not guaranteed), there are other considerations as well. For a young trans woman for instance, 2 years could mean the difference between needing FFS or not, hair transplants or not, or thousands more on her electrolysis bill.
And once that bell rings for transition, every day spent waiting is a lifetime, no matter the age.

I have to agree with Nero on this, even the younger people can have very specific age related reasons to move forward. The younger you can begin the better the results.

I think a lot of what is being said isn't taking one truth into consideration, each individual is in fact an INDIVIDUAL. What is right for one person may not be what is right for the next one, or it may be exactly what is right for the next person. You never know until you take the time to get to know these people as individuals, which is exactly what therapists are supposed to be doing.

To say that younger people can stand to wait longer but they have a "me, me, me" feeling about moving forward is kind of ironic in my opinion since pretty much every person who has said that is someone who is older and is also displaying the "me, me, me" attitude with their statements that while younger people can wait THEY COULDN'T wait because they are older. To me it's the same thing. You personally may actually feel that you are old enough to know best and that you have no time to waste, at the same time there could be someone out there 40 years younger than you who actually knows better and shouldn't have to waste that time either.

Being older doesn't give you an automatic pass on rather or not your actions are self serving and egotistical. To me it seems like that is basically what the "I want it now" idea is, people who are only looking out for themselves with no care of how their actions or desires could hurt those around them. Being 70 doesn't change how it will/could/did change the lives of those you love anymore than it changed the lives of people I love at 23. Being 70 doesn't make it automatically a wisdom filled well thought out idea/plan either. I've met plenty of older people who didn't have a ->-bleeped-<-ing grip on what they were doing or saying at all and were no better than teenagers I've met when it came to their ability to make choices for their lives. At the same time I've met many 14 year olds who were capable of being rational and reasonable just as we'd expect someone who is much older to be.

[cynthialee]

I see nothing wrong with the I want it now attitude if it is a reasonable thing to want.
HRT for a transsexual is reasonable.

Being FORCED to participate in a diagnosic or anyother medical ballyhoo you do not agree with is a form of submision to a rape of the soul. Just because someone MAY get harmed is not a valid reason to hold me or anyone else back from what they want. I did not want to discuss my very personal feelings and thoughts with anyone I havent decided to do so with.

(BTW: I did go the SOC route and will continue to do so. But I do not like it that my soul and body are apropriated by the medical comunity to further their goals and ideals.)

[Cowboi]

I see nothing wrong with the I want it now attitude if it is a reasonable thing to want.
HRT for a transsexual is reasonable.

Being FORCED to participate in a diagnosic or anyother medical ballyhoo you do not agree with is a form of submision to a rape of the soul. Just because someone MAY get harmed is not a valid reason to hold me or anyone else back from what they want. I did not want to discuss my very personal feelings and thoughts with anyone I havent decided to do so with.

(BTW: I did go the SOC route and will continue to do so. But I do not like it that my soul and body are apropriated by the medical comunity to further their goals and ideals.)

Honestly, I don't get it at all. What common goal does the medical community have that is furthered by suggesting that we speak to a therapist for 3 months to ensure we are aware of the choice are making and that we are stable enough to decide for ourselves? What are they really getting out of that other than our protection as patients and their protection as medical providers? How are they harming your body or soul by ensuring that you are aware of what will happen and that you are capable of making this choice?

Everyone seems to want to overlook the facts that not all changes from HRT are reversible. What about things like potentially becoming sterile? That is not something that is reversible.

For example, in my situation I began living full time as male when I was 15 and began T when I was 23. By the end of that 8 years I was certain I did not want children and considering I lead a lifestyle of dating women exclusively I just figured that since the children would not genetically belong to both of us anyhow it wouldn't really hurt me to allow my partner to play that role. So I moved forward with HRT. I had no way of knowing then that 3 years later I would be building my life with a partner who is also transsexual, someone I could have had OUR children with, children that belonged to both of us and came from both of us genetically. At this point it is most likely (granted not for sure since we have not been tested) that neither of us can have children, now I have to live with the reality that neither my partner nor myself can have children and adoption (at least where we live) is NOT an option for trans people at all. It is a reality that for us to have children we'd have to hope for a miracle in the courts as well as uproot our lives, move away from our families, school and careers to even have a hope of being allowed to adopt. All of which may pan out to still being told no.

I never thought I'd have to deal with this issue, logically it seemed like I had the exact answer that would fit my life and allow me to make this choice later down the road. A luxury I no longer have that was taken away from me by ONE choice in life, moving forward with HRT. And I was perfectly informed and able to consent at the time that I did so.

I also don't agree with everyone pushing forward with the idea of informed consent because some people NEED HRT right away. If someone is in the immediate danger of self harm or suicide they shouldn't just be given access to medical procedures that require rational thought and clarity to consent to, they should be treated just as any other patient would be. We are not special because our depression comes from being trans. The common route for people at risk of suicide is hospitalization, to want to kill yourself is NOT rational regardless of what the reasons behind the feelings are or how easy it may be to fix/treat the situation. Not being rational, in my opinion, is a barrier to informed consent and the ability to actually consider all sides of the issue to make a choice.

Three months is not only just a SUGGESTION (something else that seems to keep being ignored but has been pointed out several times already) it's also a very very very short time period. You are definitely not missing out on a huge portion of your life by waiting a quarter of one year to begin treatment. If you are suicidal being hospitalized for part (if not all) of that waiting period would probably be a good thing for you anyhow. Even if your depression will go away with treatment you will have learned healthy ways to deal with depression if it visits again in your lifetime, those coping skills will definitely come in handy at some point in life for someone who obviously does not have them and needs to learn them to begin with.

I waited 8 years (I certainly don't think everyone should wait that long, just happens to be my number) by doing so I was allowed several opportunities to learn about all of the ways this would change my life. It also allowed a period of time for the people who are important in my life to adjust to the changes I would be facing, they are prepared to assist me, stand by me and support me through this entire experience. I also know that I will not loose any of the people who are in my life because of this choice, a luxury and comfort not all of us have but that many could have had if they ever allowed that opportunity to be present for the people they cared for. True for some of us no amount of time would have changed the people we lost, but it would have allowed for the time to deal with the reality of the loss and the reasons behind it in a healthy way.

[cynthialee]

I was sterile long before I started HRT.

If I would have waited 1 more day to start HRT when I did (1 month after coming out of the closet I lived in for 32 years) I would have likely shot myself instead. So 3 months to me would have been an eternity.

[Cowboi]

I was sterile long before I started HRT.

If I would have waited 1 more day to start HRT when I did (1 month after coming out of the closet I lived in for 32 years) I would have likely shot myself instead. So 3 months to me would have been an eternity.

Which actually just circles around to one of my points, people who are in immediate danger of self harm or suicide should be hospitalized. In a hospital you would not have been able to (nor had the option to) shoot yourself. Suicide/self harm is now an impossibility and therapy can continue to get you on HRT while you are in a safe environment protected from the one person who was actually your enemy from the beginning, yourself.

Additionally I have to ask (this is a long thread so I'm not really into reading back through everything) but aren't you the same person who asked why people should be protected from themselves? If so you just answered your own question. Someone needed to protect you from yourself because you are a worthwhile, intelligent, individual who (from every post I've seen of yours on here) has people around that you love and care for deeply who would have taken their own life. In my opinion everything you are is worth protecting, even if the only danger is yourself.

[cynthialee]

That makes no sense.
I was the one who saved my own ass. I ordered the HRT myself. I told no one I was suicidal. How could anyone have hospitalized me when I was so good at hideing my self hatred?

[Christine Snider]

My waiting period is already way past 3 months. I guess it is because I am so young and my psychologist wants to be extra sure this is the right thing for me. She is a very good psychologist and very experienced with Transgender patients. I am having a very hard time waiting though..... I wanted to start HRT 2 months ago. Would it be reasonable for me to give her a timeline of when I would like to begin my HRT?
Do you all think starting HRT this coming up March/April and then adjusting over the summer so I can go full time when I go back to school in the fall would be reasonable?

[Cowboi]

That makes no sense.
I was the one who saved my own ass. I ordered the HRT myself. I told no one I was suicidal. How could anyone have hospitalized me when I was so good at hideing my self hatred?

While your experience is valid I don't feel that someone who didn't actually go through the appropriate channels can outweigh the opinions and thoughts of those who did. The point is still valid, but I don't think it's as strong of one in a discussion like this.

Consider if you had gone through therapy and you had talked about your suicidal feelings, how could things have worked differently? How could that have changed your experience and in turn changed your opinion on the 3 month suggested waiting period for HRT?

If you don't admit to your problems no one can help you, obviously. And if you don't allow them the chance to help you then you really shouldn't step up to the plate and critic the standards. It's similar to never trying a certain food because you are sure you won't like it, if you did try it you might find it isn't as bad as you thought. True, you may still not like the food, but you can't really judge that it's horrible or not without actually taking a taste. I know that is a pretty loose comparison, but just the first one that came to mind for an example

If you'd gone to therapy and received appropriate care and help your opinion on the waiting period may be much different than it is currently.

[Cowboi]

My waiting period is already way past 3 months. I guess it is because I am so young and my psychologist wants to be extra sure this is the right thing for me. She is a very good psychologist and very experienced with Transgender patients. I am having a very hard time waiting though..... I wanted to start HRT 2 months ago. Would it be reasonable for me to give her a timeline of when I would like to begin my HRT?
Do you all think starting HRT this coming up March/April and then adjusting over the summer so I can go full time when I go back to school in the fall would be reasonable?

It sounds very reasonable, I'd say to definitely broach the subject with her. If your psychologist is even half as good as my therapist you will at least learn why they are making you wait longer. With my therapist the only reason she waited was because I never asked after 3 months. I asked when I was ready and she gave me the note the same day   Sometimes they are waiting on us, and other times if we just bring it up we can discuss a time line like you mentioned and have something set up that we know we are working towards, which can help a lot.

[cynthialee]

The fact that there was a waiting period at all was my impetious to self medicate.

[Cowboi]

The fact that there was a waiting period at all was my impetious to self medicate.

Haha, sorry, I redid my post

I realized how crappy and emotional I was in my first response, my apologize. I actually was just going to add on to it and apologize then but hoped that maybe it had not been read yet lol. My wording was really rude, so I tried to rethink what I was saying and present it in a more appropriate way

[Cowboi]

The fact that there was a waiting period at all was my impetious to self medicate.

As an actual response to this statement I just have to say once again that the waiting period is only a suggestion not a requirement. You allowed the waiting period to push you into handling things your own way, did you at least pursue therapy first and were told you'd have to wait? Also if you did why didn't you bring up your feelings of suicide then? It is what therapy is intended for after all, a chance to talk about how you feel. Some therapist have actually pushed through suicidal patients because they are aware of the dangers, rather than choosing hospitalization or additional therapy some doctors allow HRT right away when presented with a case like yours.

[cynthialee]

I did pursue therapy. The first go around (this time, not counting my 20's) after I went to the local comunity mental health I said I had gender issues and they showed me the door.
I then found the SOC, and I read it of course and I saw the waiting period and I couldnt wait. I got ahold of HRT as fast as I could. When I saw my doctor a couple months later he freaked and gave me a proper prescription and ordered some tests. (after being forced to by my wife and my HIV care case manager.)

I knew I would get HRT from my doctor due to the harm reduction clause in the SOC.

Before I even saw my doctor and landed the transsexual bomb on him I had found a gender therapist and I have been seeing her for a year now.

apology acepted